St.

Paul University Dumaguete

(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

IN PARTIAL FULFILLMENT OF THE REQUIREMENT IN NCM 109: Care of the

Clients across lifespan with Mother, Child, and Families at risk or with Problems

SUBMITTED TO:
Mrs. Sharry Mae G. Awayan RN, MAN

SUBMITTED BY:
HANNAH O. CAGAMPANG

DATE:
JUNE 2, 2023
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

DRUG STUDY

Salbutamol
Generic Name: Albuterol
Brand Name: Salbutamol
Drug Classification: Bronchodilator (Respiratory Smooth Muscle Relaxant); Autonomic
Nervous System Agent; Beta-Adrenergic Agonist (Sympathomimetic)
Indications:
To alleviate the narrowing of the airways in conditions like acute or chronic asthma, bronchitis,
and other reversible obstructive lung diseases, as well as to prevent exercise-induced airway
constriction.
Contraindications:
Contraindicated in patients with high blood pressure during pregnancy, uterine infection,
miscarriage, heart disease, and hypersensitivity.
MOA:
Synthetic sympathomimetic amine and moderately selective beta 2-adrenergic agonist with
comparatively long action. Acts more prominently on beta 2 receptors (particularly smooth
muscles of bronchi, uterus, and vascular supply to skeletal muscles) than on beta 1 (heart)
receptors. Inhibits histamine release by mast cells. Produces bronchodilation, regardless of
administration route, by relaxing smooth muscles of bronchial tree.
Usual Dosing/Route of Administration:
Bronchospasm
Adult: PO 2–4 mg 3–4 times/d, 4–8 mg sustained release 2 times/d Inhaled 1–2 inhalations q4–
6h Child: PO 2–6 y, 0.1–0.2 mg/kg t.i.d. (max: 4 mg/dose); 6–12 y, 2 mg 3–4 times/d Inhaled 6–
12 y, 1–2 inhalations q4–6h
Side/Adverse Effects:
• Trembling, particularly in the hands, ervous tension, headaches, suddenly noticeable
heartbeats (palpitations), muscle cramps and hypersensitivity reactions
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

Important Nursing Considerations:

• Monitor the effectiveness of treatment by observing significant improvement in breathing
function within 60-90 minutes after taking the medication.
• Be vigilant for signs and symptoms of fine trembling in the fingers that may affect fine motor
skills, as well as CNS stimulation, especially in children aged 2-6 years, such as
hyperactivity, excitement, nervousness, and difficulty sleeping.
• Periodically conduct laboratory tests such as arterial blood gases (ABGs), pulmonary
function tests, and pulse oximetry.
• Consult with a physician regarding the timing of the last dose of albuterol to be taken several
hours before bedtime if the medication causes insomnia.
Health Teachings:
• Familiarize yourself with the proper usage instructions for the medication and inhaler.
• Avoid getting the inhaled medication in contact with your eyes.
• Do not increase the number or frequency of inhalations without consulting a physician.
• Inform your doctor if albuterol does not provide relief, as it may indicate a decline in lung
function and require a reassessment of your condition and treatment.
Budesonide
Generic Name: Budesonide
Brand Name: Entocort EC, Pulmicort Turbuhaler, Rhinocort, Rhinocort Aqua, Rhinocort
Turbuhaler
Drug Classification: Hormone and Synthetic Substitute; Adrenal Corticosteroid;
Glucocorticoid; Mineralocorticoid
Indications:
Treatment of allergic and perennial rhinitis, maintain remission in mild to moderate Crohn's
disease, prophylaxis for asthma.
Contraindications:
Contraindicated in any patients with a history of hypersensitivity to budesonide or any of the
ingredients of the budesonide formulation; Contraindicated in patients with severe milk protein
allergies.
MOA:
Has potent glucocorticoid and weak mineralocorticoid activity. Its anti-inflammatory action on
nasal mucosa is unknown.
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

Usual Dosing/Route of Administration:

Powder Inhaler:
Adults and children 6 years of age and older: At first, one or two puffs two times a day. Children
younger than 6 years of age: Use and dose must be determined by your doctor.
Suspension in a Nebulizer:
Children 12 months to 8 years of age: 0.5 to 1 milligram (mg) in a nebulizer once a day, or
divided and given twice a day. Each container of liquid has one dose and a new container is used
for each dose.
Infants younger than 12 months of age: Use and dose must be determined by your doctor.
Side/Adverse Effects:
• Fever, Headache, Stomach Pain or Indigestion, Muscle Pains, Bronchospasms, White spots
in mouth or food pipe (Thrush)

Important Nursing Considerations:

• Monitor closely for S&S of hypercorticism if concomitant doses of ketoconazole or other
CYP3A4 inhibitors.
• Monitor patients with moderate to severe liver disease for increased S&S of hypercorticism.
• Lab tests: Periodic serum potassium.
Health Teachings:

• Notify the physician immediately for any of the following: itching, skin rash, fever, swelling
of face and neck, difficulty breathing, or if you develop S&S of infection.
• Do not drink grapefruit juice or eat grapefruit regularly.
• Avoid people with infections, especially those with chicken pox or measles if you have never
had these conditions.

Duavent
Generic Name: Duavent
Brand Name: Ipratropium Bromide + Salbutamol
Drug Classification: Combination of Adrenergics with Anticholinergics; Corticosteroid
Indications:
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

To treat reversible narrowing of the airways in conditions like asthma. It is intended for
individuals with chronic obstructive pulmonary disease (COPD) who are already using a regular
inhaled bronchodilator but still experience symptoms of airway constriction and need an
additional bronchodilator.
Contraindications:
Contraindicated in patients with atropine hypersensitivity, albuterol hypersensitivity, or their
respective derivatives.
MOA:
The combination of Ipratropium bromide and Salbutamol enhances the effectiveness of
treatment in individuals with bronchial asthma and chronic obstructive pulmonary disease
(COPD) by utilizing two distinct mechanisms that promote bronchodilation. These mechanisms
include the anticholinergic (parasympatholytic) effect and the beta2-agonist (sympathomimetic)
effect.
Usual Dosing/Route of Administration:
Metered Dose Inhaler:
Pulmoneb Adult, adolescent >12 yr & elderly Acute
attacks 1-2 pulmoneb.
Maintenance: 1 pulmoneb every 6-8 hr daily.
Childn 2-12 yr 3 drops/kg/dose. Max: 2.5 mg of salbutamol every 6-8 hr.
MDI Adult & childn > 12 yr 2 actuations 6 hrly. Max: 12 actuations in 24 hr.
Side/Adverse Effects:

• Nervousness, Dizziness, Headache, Flushing, Reduced appetitecns Stimulation Important

Nursing Considerations:
• Assess the patient's respiratory status, including lung sounds, respiratory rate, and oxygen
saturation levels.
• Monitor the patient's respiratory function and response to treatment.
• Assess the effectiveness of bronchodilation, improvement in symptoms, and any adverse
reactions.
• Be aware of potential drug interactions with Duavent, especially other bronchodilators or
medications that may affect the cardiovascular system.
Health Teachings:
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

• Provide detailed instructions to the patient regarding the correct usage of Duavent, including
proper inhaler technique. Emphasize the importance of adhering to the prescribed dosage and
schedule.
• Educate the patient about possible side effects of Duavent, such as dry mouth, headache,
tremors, palpitations, or increased heart rate. Instruct them to report any unusual or severe
reactions.
• Ensure that the patient understands how to use the Duavent inhaler correctly.
• Encourage the patient to adhere to the prescribed treatment plan and attend scheduled
followup appointments.
Paracetamol
Generic Name: Acetaminophen, Paracetamol
Brand Name: Tempra Forte
Drug Classification: Central Nervous System Agent; Nonnarcotic Analgesic, Antipyretic
Indications:
Fever reduction. Temporary relief of mild to moderate pain. Generally as substitute for aspirin
when the latter is not tolerated or is contraindicated.
Contraindications:
Contraindicated in patients with known hypersensitivity to acetaminophen (paracetamol).
Patients with anemia, cardiac, pulmonary, renal and/or liver diseases must consult first with their
physician before taking this drug.
MOA:
Produces analgesia by unknown mechanism, perhaps by action on peripheral nervous system.
Reduces fever by direct action on hypothalamus heat-regulating center with consequent
peripheral vasodilation, sweating, and dissipation of heat. Unlike aspirin, acetaminophen has
little effect on platelet aggregation, does not affect bleeding time, and generally produces no
gastric bleeding.
Usual Dosing/Route of Administration:
Mild to Moderate Pain, Fever
Adult: PO 325–650 mg q4–6h (max: 4 g/d) PR 650 mg q4–6h (max: 4 g/d)
Child: PO 10–15 mg/kg q4–6h PR 2–5 y, 120 mg q4–6h (max: 720 mg/d); 6–12 y, 325 mg q4–
6h (max: 2.6 g/d)
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

Neonate: PO 10–15 mg/kg q6–8h Side/Adverse

Effects:

• Bloody or black, tarry stools, Bloody or cloudy urine, Fever with or without chills, Pain in
the lower back and/or side (severe and/or sharp), Pinpoint red spots on the skin, Skin rash,
hives, or itching
Important Nursing Considerations:

• Monitor for S&S of hepatotoxicity, poisoning and potential abuse from psychological
dependence.
Health Teachings:
• Do not take other medications (e.g., cold preparations) containing acetaminophen without
medical advice.
• Do not self-medicate adults for pain more than 10 d (5 d in children) without consulting a
physician.
• Do not use this medication without medical direction for: fever persisting longer than 3 d,
fever over 39.5° C (103° F), or recurrent fever.
• Do not give children more than 5 doses in 24 h unless prescribed by physician.

Cefixime
Generic Name: Cefixime
Brand Name: Suprax
Drug Classifications: Anti-infective; Antibiotic; Third-Generation Cephalosporin Indications:
To treat certain infections caused by bacteria such as bronchitis (infection of the airway tubes
leading to the lungs); gonorrhea (a sexually transmitted disease); and infections of the ears,
throat, tonsils, and urinary tract.
Contraindications:
Patients with known allergy to the cephalosporin group of antibiotics.
MOA:
Cefixime is bactericidal and is stable to hydrolysis by many beta-lactamase. It has a mode
of action and spectrum of activity similar to that of the third-generation cephalosporin
cefotaxime, but some enterobacteriaceae are less susceptible to Cefixime.
 St. Paul University Dumaguete
(St. Paul University System)
Dumaguete City, Negros Oriental Philippines
COLLEGE OF NURSING DEPARTMENT

Usual Dosing/Route of Administration:

Children 6 months to 12 years of age: Dose is based on body weight and must be
determined by your doctor. The dose is usually 8 milligrams (mg) per kilogram (kg) of body
weight per day, taken as a single dose or divided in two doses (4 mg/kg of body weight every 12
hours).
Side/Adverse Effects:

• Ash, Itching, Hoarseness, Trouble Breathing, Trouble Swallowing, or Any Swelling of Your
Hands, Face, or Mouth, Diarrhea
Important Nursing Considerations:

• Determine previous hypersensitivity reactions to cephalosporins, penicillins, and history of

other allergies, particularly to drugs prior to initiation of therapy.
• Lab tests: Perform culture and sensitivity tests prior to initiation of therapy and periodically
during therapy.
• Discontinue if seizures associated with the drug therapy occur.
• Monitor for superinfections caused by overgrowth of nonsusceptible organisms, particularly
during prolonged use.
• Monitor I&O rates and pattern: Nephrotoxicity occurs more frequently in patients >50 y,
with impaired renal function, in the debilitated, and in patients receiving high doses or other
nephrotoxic drugs.
• Report manifestations of hypersensitivity.
• Promptly report loose stools or diarrhea, which may indicate pseudomembranous colitis.
Health Teachings:
• Report loose stools or diarrhea during drug therapy and for several weeks after.
• Take this antibiotic for the full course of treatment.
• Do not miss any doses and take the doses at evenly spaced times, day, and night.